Provider Demographics
NPI:1457417347
Name:ANDERSONS THRIF-T DRUGS INC
Entity Type:Organization
Organization Name:ANDERSONS THRIF-T DRUGS INC
Other - Org Name:THRIF T DRUGS@ MARKETPLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-484-4338
Mailing Address - Street 1:4350 BAYOU BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1948
Mailing Address - Country:US
Mailing Address - Phone:850-484-4338
Mailing Address - Fax:850-484-0497
Practice Address - Street 1:4350 BAYOU BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-1948
Practice Address - Country:US
Practice Address - Phone:850-484-4338
Practice Address - Fax:850-484-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
FLPH110333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2009977OtherPK
FL022781100Medicaid
FL022781100Medicaid